One Dosage Doesn't Fit All

Researchers are working to revolutionize how medical professionals determine drug treatment plans for children and youth facing devastating diagnoses at Children’s Hospital, London Health Sciences Centre.

Currently, standard dosing practices dictate that every patient receives an average dose of the medications required to fight their disease or illness. However, in certain instances, this can have serious consequences.

A child’s genes define their ability to tolerate medications, and every patient metabolizes drugs at different rates. Some children have extra ability, due to their genetics, to break down drugs rapidly, which can result in medications becoming ineffective. Others cannot process certain drugs at all, leading the child to experience dangerous and severe toxicity.

Recognizing that every child is different, Dr. Richard Kim, a world renowned clinical pharmacologist with Children’s Health Research Institute (CHRI), and a team of researchers are taking steps to introduce a personalized approach to drug therapy at Children’s Hospital. Currently, his team is focused on helping patients who have leukemia or inflammatory bowel disease.

Using cutting-edge technology and backed by a wealth of literature, Dr. Kim and his team are able to analyze children’s DNA to predict how they will metabolize certain prescription medications, such as the commonly used chemotherapy Mercaptopurine. They then make recommendations to the health care practitioners about which dose that particular child will be able to safely tolerate or possible alternative therapies to explore.

Dr. Kim’s goal is to eventually integrate personalized medicine into everyday patient care, ensuring all children receive the maximum benefit from medications but with the least risk.

“The development of Personalized or Precision Medicine, by helping us understand how genetics can impact drug effectiveness and safety, allows us the opportunity to predict which individual child is safe or at risk prior to drug treatment,” shares Dr. Michael Rieder, chair/chief of the Department of Paediatrics at Children’s Hospital. “It is increasingly clear that these approaches will greatly enhance the ability of our child health care teams to provide effective and safe treatment for all of the children we have the privilege to care for.”


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